Introduction– The medical definition of recurrent implantation failure- is when the embryo fails to implant in the uterus – 4 healthy embryos have been used at a minimum, in 3 consecutive cycles. It can be soul crushing, having to go through all those steps in an IVF cycle, multiple times and still have to walk away with a negative pregnancy test, 2 weeks after the latest embryo transfer.

You will need to walk in to Feminova Clinics- the best IVF Clinic In Hyderabad or talk to the Best IVF Doctor In Hyderabad to understand why this may be happening and what has to change for better outcomes in the future. 

Reasons Why Recurrent Implantation Failure Occurs- 

Doctors tend to look at two distinct areas where problems may have risen- 

Issues with the embryo itself– An embryo that looks healthy and normal under a microscope may be carrying certain DNA mutations which cannot be seen by the naked eye. When such embryos are used, implantation may not occur at all, or there is a greater risk of a miscarriage later on. 

Tests done to check include- 

• PGT-A – Errors in DNA tend to accumulate within age, which is why it is better to get them checked with a specialised test called PGT-A – Preimplantation genetic testing for aneuploidy. This test checks if the embryo has a lower or higher number of chromosomes, when compared to the normal 23 pairs. After the results are obtained, embryo transfer can be done in the next session. 

• Sperm DNA fragmentation– If the sperm DNA has been fragmented or mutated due to poor lifestyle related factors, exposure to excessive heat, smoking, drinking or other possibilities, then this specialised test is done to check if the genetic material in the sperm cells are sound enough to be used for fertilisation of a matured egg later on. 

If these tests come back with normal or no troublesome findings, then doctors will check the next possibility- if the uterus is healthy enough and the endometrial lining is receptive for implantation to occur. 

Tests done include- 

• Detailed imaging to check for fibroids, polyps or any other structural abnormalities in the uterus which can hamper implantation. Extensive scar tissue formation from previous surgeries or infections due to inflammation or even the formation of a septum can be problematic. A 3D ultrasound scan and hysteroscopy is done to check for any of these anomalies. 
• Thickness of endometrial lining– A thin endometrial lining does not support implantation. It needs to be the right thickness- 7-14mm; higher and lower numbers can affect implantation adversely. Different protocols may need to be used with estrogen to increase thickness if it is lower than the threshold. 
• Endometritis which is chronic- Recurrent inflammation of the endometrial lining can impact implantation severely, even if there is no real infection present. Endometrial biopsy can help ascertain if cells are chronically inflamed and this is normally treated with antibiotics. 

A few specialised tests include-

• ERA Test – When the doctor does the embryo transfer is also paramount for implantation to occur- this is where an ERA test comes in- endometrial receptivity analysis check when the endometrial lining is its most receptive at the peak of the luteal phase, so that the embryo can implant with ease after transfer. Some women may have this window occurring earlier or later than in the luteal phase, which can interfere with implantation – this is a displaced implantation window. 
• Immune Testing- Some women may also have a hyperactive immune system where the immune cells target the newly growing embryo. Specific tests include- NK or natural killer cells testing, antiphospholipid antibody testing (to check for blood clotting in the uterine blood vessels) and thrombophilia screening – where blood clots more easily than usual. 

Conclusion– RIF can be hard to deal with and all these tests can be confusing too- as there is so much going on. What you can do is continue eating healthy, maintain a healthy BMI, not expose yourself to smoke or alcohol, make sure you have enough Vitamin D and learn how to manage stress better.

So call us at Feminova Clinics- if you have been searching for the best Gynecologist in Nallagandla, Gynecologist Near Chanda Nagar, Best Doctor For Pregnancy Near Me or the best Fertility Clinic In Hyderabad online, right away! 

Can’t find an answer? Book a clinic visit or Call us  at +91 9966888702 or +91 8125860069